The Fairlawn Swim & Tennis Club, Inc.

APPLICATION FOR MEMBERSHIP

Return to:

Fairlawn Swim and Tennis

P.O. Box 5136

Akron, OH 44334

The sponsor is to complete the following application for membership. Sponsors for applicants may e-Mail letters

of recommendation to either Alan Ephlin via e-Mail at aephlin@gmail.com or Ryan Grass via e-Mail at ryangrass@neo.rr.com .

Name: ______________________________ Home Phone: ________________________

Address: ________________________________________________________________

City: _____________ State: _____________ Zip: ______________

e-Mail Address:__________________________________________

Occupation: _______________________________________ Date of Birth: __________

Business Address: ________________________________________________________

Business Phone Number: _______________________

Spouse’s Name: ____________________________________ Date of Birth: __________

Affiliations & Clubs: ______________________________________________________

_______________________________________________________________________

Children’s Names Date of Birth

__________________________________________ ________________________

__________________________________________ ________________________

__________________________________________ ________________________

_______________________________________ ______________________________

Sponsor’s Signature Date Applicant’s Signature Date

_______________________________________ ______________________________

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